Single Antiplatelet Therapy Significantly Lowers Mortality Risk in TAVR Patients

Recent findings from the TRITAVI registry reveal that using a single antiplatelet drug (SAPT), such as aspirin, after transcatheter aortic valve replacement (TAVR), substantially reduces the risk of death and severe bleeding within six months. Presented at the SCAI 2025 Scientific Sessions, this data suggests a shift in post-procedure management for patients with severe aortic stenosis.

Currently, the standard care following TAVR involves SAPT due to its lower bleeding risk compared to dual antiplatelet therapy (DAPT). However, until now, evidence regarding its impact on mortality had been inconclusive. As TAVR procedures become increasingly common, understanding optimal medication strategies is critical.

The study analyzed 5,514 patients discharged on either SAPT (3,197 patients) or DAPT (2,317 patients), with an average age of 81.5 years. Results showed that patients on SAPT experienced notably lower rates of mortality and major bleeding at six months—2.4% versus 5.4% for mortality, and 0.5% versus 1.3% for bleeding. Additionally, SAPT was associated with reduced cardiovascular and non-cardiovascular deaths.

Further analyses indicated that DAPT's association with increased mortality was consistent across genders and regardless of the presence of coronary artery disease. Notably, even high-risk groups, such as those with coronary artery disease, benefited from SAPT.

Lead researcher Dr. Francesco Pelliccia emphasized that these findings challenge current practices, highlighting that SAPT may be the preferable regimen for all patients undergoing TAVR, including those at higher bleeding risk. This evidence could influence clinical guidelines, optimizing patient outcomes post-TAVR.

For more details, visit the full study at ScienceX.